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Date: 2012-12-21
Presenter: R2
Instructor: VS
Definition
A surgical procedure in which gingival pockets are eliminated by removal of gingiva.
Indications
1. Gingival enlargement or overgrowth
2. Idiopathic gingival fibromatosis 3. Pseudopockets 4. Shallow suprabony pockets modified Widman 5. Areas with difficult access
Contraindications
1. Narrow or absent attached gingiva
2. Infrabony pockets 3. Thicking of marginal alveolar bone
Advantages
1. Technically simple; good visual access
2. Complete pocket elimination 3. Predictable morphological result
Disadvantages
1. 2. 3. 4. 5. 6. Very limited indications Gross wound; postoperative pain Healing is by secondary intention (ca. 0.5 mm/day) Danger of exposing bone Loss of attached gingiva Exposes cervical area of tooth (sensitivity, esthetics, caries) 7. Phonetic and esthetic problems in anterior area
Instruments
Size, shape and angulation of the working tip, and also by the comfortable handle Gingivectomy knife + papilla knife, singly or doubly angled
Paired (L & R) Use: indicate the location of the base of the pocket
Gingivectomy knives
Sharpness!
Arkansas stone + oil
Gingivectomy knives
45 angle to the tooth long axis Anterior area: single-bend Less accessible area: double-bend
Use: gingiplasty, papillectomy, smooth out abrupt edges, expose the margins of a tooth preparation before taking the impressions or seating a restoration Hemostatic effect Not recommended for primary gingivectomy injury to the root, periosteum or bone
Peripac: ready-to-use, gypsum base + acrylic, sets quickly when contacting with saliva, hard edgesdanger of pressure aphthous ulcer Coe-pak: 2 component (zinc oxide + fatty acids), pliable after setting
Tissue adhesives (Cyanoacrylate): Histoacryl, Bucrylate Use: minor GV/GP wounds, instead of sutures Applied by plastic tubes, brushes or cannulate
Operative Procedure
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Anticonvulsants
Immunosuppressants
1. Phenytoin for seizure 2. Valpronic acid, carbamazepine, phenobarbitone rare 3. Vigabatrin new
1. Antihypertensive drugs for angina or peripheral vascular disease 2. Nifedipine first in early 1980s 3. Diltiazem, verapamil 4. Amlodipine, felodipine rare
1. Cyclosporin A for prevention of transplant rejection, autoimmune like rheumatoid arthritis limited by renal, cardiac, and gingival fibrosis
J Periodontol 2004;75:1424-1431.
Prevalence
children
J Periodontol 2004;75:1424-1431.
Prevalence
J Periodontol 2004;75:1424-1431.
References
1. Color Atlas of Dental Medicine: Periodontology: Periodontology. Herbert F. Wolf, Klaus H. Rateitschak 2. Informational Paper - Drug-Associated Gingival Enlargement, J Periodontol 2004;75:1424-1431.
MERRY CHRISTMAS~!!